keskiviikko 24. toukokuuta 2017

Depression overdiagnosed by questionnaire developed by drug company

Depression overdiagnosed by questionnaire developed by drug company


About the author: Bryan Hubbard

People are being diagnosed with depression with a simplistic point-scoring questionnaire that was developed by the drug company that has some of the leading antidepressant brands, and so is most likely to benefit from a diagnosis and prescription. 

There's a danger that depression is being overdiagnosed by busy family doctors, who are not trained in psychiatric problems and instead rely on the PHQ-9 questionnaire, which was developed by Pfizer, the drug company that makes the top-selling antidepressants Zoloft (sertraline) and Effexor (venlafaxine).

Although an antidepressant prescription can be determined by responses to the PHQ-9, a major study has found that it is inadequate, and shouldn't be relied on for a clinical diagnosis. Researchers from the University of Leicester looked at 40 previously-published studies, involving 14,760 adults, 14 per cent of whom had major depression. The test can't accurately identify cases of depression, but can only rule out patients who aren't depressed, the researchers concluded.
The PHQ-9—or Patient Health Questionnaire—asks nine questions that have four possible answers, from 'not at all' to 'nearly every day'. The patient is asked whether he or she has little interest or pleasure in doing things, feels down or depressed, has trouble sleeping, feels tired, has poor appetite, feels bad about themselves, has trouble concentrating, moves or speaks slowly, and has thoughts of self-harm or wanting to be dead.
The answers notch up scores that range from 0 to 27, and an antidepressant prescription can be triggered by the doctor's judgement and any score that is above 10.

(Sources: Br J Psych Open, 2016; 9: 127-38; Daily Telegraph, May 22, 2017)


Antidepressants: they don't work (but don't tell anyone)

in About the author:  WDDTY Team 

You'd think it is enough of a scandal that doctors are prescribing powerful antidepressants to two-year-olds, but now we're told that one pharmaceutical suppressed findings that the drugs weren't even working

You'd think it is enough of a scandal that doctors are prescribing powerful antidepressants to two-year-olds, but now we're told that one pharmaceutical suppressed findings that the drugs weren't even working.
It's been announced this week that GlaxoSmithKline, the UK's largest drug company, avoided publishing the data because it was concerned the findings would affect its lucrative adult market for the drug.
Two major clinical trials, codenamed protocols 329 and 377, tested Seroxat (paroxetine) on a group of children and adolescents with major depression and found that the drug was no more effective than a placebo, or sugar pill.
Despite these findings, GlaxoSmithKline was also aware that the drug caused suicidal tendencies, especially among the young.
The full findings of the studies, which were carried out in 1998, came to light only last spring when the UK regulator, the Medicines and Healthcare Products Regulatory Agency, banned the drug for use among children because it was ineffective and unsafe.
The revelation is but the latest twist to a scandal that is worrying regulators in the UK and the USA. America's drug watchdog, the Food and Drug Administration, has finally agreed to review the practice of prescribing antidepressants to children. The drugs are not in any event licensed for use among children, but doctors are free to prescribe them if they feel it is an appropriate therapy.
As we outlined in E-news 58, around 2 per cent of all youths in the USA are prescribed an antidepressant. This unlicensed usage increased by 400 per cent between 1988 and 1994 alone.
The FDA has conceded that the drugs are more likely than placebo to cause suicidal thoughts, although nobody knows how many children have attempted or committed suicide while taking an antidepressant.
We recall an encounter we once had with Dr Thomas Stuttaford, the medical correspondent for the London Times. 'The trouble with you (What Doctors Don't Tell You and all like us),' he said, 'is that you don't realize that when you have a sharp sword (an effective drug), some heads will be cut off (there will be adverse reactions).' It appears that blunt swords can also decapitate, too.
(Sources; The Guardian, 3 February 2004; Journal of the American Medical Association, 2003; 290: 1033-41).

Antidepressants: deaths from these drugs are enough to make you depre

About the author: WDDTY Team

We're always told that drug prescribing is all about a careful balance between risk and benefit
We're always told that drug prescribing is all about a careful balance between risk and benefit. People suffering from severedepression do need help, and occasionally a prescribed antidepressant can be helpful.
But new research reveals that doctors need to think twice before prescribing antidepressants, and patients should think three times before taking them.
Antidepressants are a far more deadly family of drugs than even their critics realized, research from Canberra Hospital in Australia shows.
The tricyclic antidepressants, for example, have killed 2,598 people in England, Scotland and Wales between 1993 and 1999. The most lethal drug has been desipramine; although it was responsible for just nine deaths, only 45,000 prescriptions were ever written, which works out at a rate of 200 fatalities for every million prescriptions.
The statistics make for sobering, and, in some cases, shocking reading. The family doctor writes the vast majority ofprescriptions for antidepressants, and these findings may stay even his hand.
Research in the past has discovered that antidepressants are also poor substitutes for greater human contact, counselling and self-help therapies.
Perhaps in the light of these new findings, these more humane, and less dangerous, approaches to the epidemic of depression will now be given their rightful place.

(Source: British Medical Journal, 2002; 325: 1332-3).

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